Zomwe anthu ambiri amakhulupirira kuti nthawi zambiri anthu amatha kugwiritsira ntchito mkodzo kuchokera ku ntchito ya impso. Choncho, lingaliro ndi lakuti ngati "mukupanga mkodzo," impso zanu zikugwira ntchito bwino. Komabe, palibe chomwe chimachokera ku choonadi, ndipo kuyesa ntchito ya impso zanu kumafuna kuyesa kalabu komanso nthawi zina kujambula.
Anthu ambiri amadziwa kuti kuyesa kupanikizika ndi njira yoyesa ntchito ya mtima wanu.
Koma mumayesa bwanji ntchito yanu ya impso? Mwinamwake mudamva madokotala akutchula mawu monga "creatinine" kapena "GFR" pofufuza momwe impso zanu zilili zabwino kapena zoipa. Ngakhale kuti pali njira zambiri zomwe impso zimagwirira ntchito, ndikufotokozera zomwe zimagwiritsidwa ntchito nthawi zambiri.
Mwachidule, mukhoza kuyang'anira ntchito ya impso kupyolera mwa:
(1) Mayeso a magazi
(2) mayesero amtundu
(3) kujambula zamagetsi
Mayesero a Magazi
Iyi ndiyo njira yowonjezereka ndipo kawirikawiri ndiyo njira yodalirika. Nthawi zambiri madokotala amapereka mayesero omwe angakhale amodzimodzi monga "mawonekedwe ofunika kwambiri (BMP)", "7," "mawonekedwe a mphuno," "GFR," ndi zina zotero. Zomwe akuyeza ndizigawo za electrolyte ndi ziwiri mankhwala ena otchedwa magazi urea nitrogen (BUN) ndi creatinine.
BUN amayesa kuchuluka kwa nayitrogeni mumagazi anu monga urea, motero dzina BUN! Mwa kuyankhula kwina, kuyerekezera ndi chiwerengero cha urea m'magazi.
Urea, monga mukudziwira, ndi gawo la nayitrogeni yomwe ilipo mu mkodzo wa zinyama zomwe zimagwiritsidwa ntchito monga feteleza. Musanayambe kunena kuti pali feteleza yomwe ikuyenda m'magazi anu, ndiloleni ndiwonetsetse kuti mafakitale omwe amagwiritsidwa ntchito mu feteleza amapangidwa mwaluso. Ndipotu, urea ndiye woyamba "organic" (ndiko kuti, mwachibadwa m'zinthu zamoyo) chigawo chomwe chinapangidwira bwino mu labotale pamene wasayansi Wachi German Friedrich Wohler anapanga ammonium cyanate mu 1828.
BUN: Mayeso Opanda Ungwiro
Ndiye n'chifukwa chiyani timayendera mlingo wa urea m'magazi? Izi ndi chifukwa chiwerengero cha magazi a urea, (kapena BUN!) Chimadalira kukula pakati pa njira zomwe zimapanga msinkhu wake wa magazi motsatira njira zomwe zimachepetsa msinkhu wa magazi. Zinthu zomwe zimawonjezera urea m'magazi zimakhala ndi zakudya zamapuloteni, zomwe zimatha kuchititsa chiwindi kuti uchititse urea, komanso kuwonongeka kwa maselo omwe amachititsa kuti chiberekero chiwonongeke. Pomaliza, ndondomeko yomwe imachepetsa mlingo wa urea m'magazi ndi impso yanu yokhoza kusokoneza urea mu mkodzo.
Poganizira kuti zinthu zomwe zimapangitsa kuti urea ukhalepo nthawi zonse, nthawi zonse mumatha kunena kuti mlingo wa urea m'magazi umadalira kwambiri impso zanu. Choncho, matenda a impso amatha kudziwika ndi kuchuluka kwa magazi a urea, kapena BUN. Komabe, chonde kumbukirani kuti izi ndizofotokozera mophweka, ndipo miyezo ya BUN, monga momwe mukuganizira, ingayambidwe ndi zakudya, catabolism, ndi chiwindi ntchito.
Creatinine Ndi Njira Yabwino
Inu simukusowa kukhala dokotala kuti muzindikire kuti BUN ndi yeseso yeniyeni yangwiro ya impso 'ntchito, poyerekeza ndi vagaries ya zinthu zambiri zomwe sizinthu zonyansa.
Kotero tiyeni tiyankhule za mankhwala ena omwe ndatchula pamwambapa: creatinine.
Mawu akuti "creatinine" amachokera ku liwu la Chigriki la thupi, ndipo ndilo chiwonongeko cha minofu. Popeza kuti minofu yanu siimasintha tsiku ndi tsiku, mlingo wa kulengedwa kwa creatinine umakhala nthawi zonse. Monga mlingo wa deininine m'magazi amamangirira (kuchokera ku kuwonongeka kwa minofu), impso zimachita ntchito yayikulu yozifotera mu dongosolo lanu. (Chochepa kwambiri, ndipo kawirikawiri chochepa (mosiyana ndi urea!) Kuchuluka kwa kulenga kumabweretsanso ndi impso, zomwe zingapangitse mphamvu ya magazi, koma kuti zikhale zosavuta, tiyeni tisanyalanyaze izo pakalipano).
Choncho, pokhala ndi minofu yowonjezereka, mlingo wa creatinine m'magazi uyenera kutsogoleredwa ndi impso kuti iwononge izo. Choncho, kuwonjezeka kwa magazi a creatinine nthawi zambiri kumatanthauza ntchito yambiri ya impso.
Magazi a creatinine amagawuni ndi ofunika kwambiri omwe angathandize madokotala kulingalira mlingo umene impso zimatsanulira magazi pogwiritsira ntchito malemba ndi zofanana (kuti mwachiwonekere sitikudandaula apa). Mphamvu imeneyo imatchedwa Glomerular Filtration Rate kapena GFR; mawu omwe mungamve kuti madokotala amaponyera mozungulira pamene akulankhula za ntchito yanu ya impso. Kwa anthu ambiri ofunika kwambiri, GFR yachibadwa imakhala pakati pa 60 ndi 120 ml / min.
Zachibadwa Zimakhala Zachilendo kwa Anthu Osazolowereka!
Kulingalira kwa GFR kumapangidwira njira yomwe yapangidwa kuti ikhale yofanana ndi anthu ozolowereka. Popeza chiwerengero chimadalira mlingo wa magazi, zomwe zimadalira minofu, sizingagwiritsidwe ntchito kwa anthu omwe ali ndi zaka zoposa (ana, anthu oposa makumi asanu ndi awiri), kapena minofu (anthu omwe amataya minofu, kulephera kwa chiwindi , etc). Mwa kuyankhula kwina, chiwerengero cha creatinine cha 1.2 (chimaoneka ngati "chachilendo" monga mabala ambiri a lababu) chingakhale chabwino kwa munthu wamtundu wofanana ndi Arnold Schwarzenegger koma akhoza kusonyeza matenda aakulu a impso pa mayi wazaka 90. Mofanana ndi msinkhu wa BUN, dokotala ayenera kudziwa nthawi yoyenera kulenga creatinine ndi ma GFR mazenera kwenikweni.
Mayesero a Mtsinje
Kuyezetsa mkodzo kuti upeze mapuloteni kapena magazi, ndipo mankhwala ake amathandiza kumasonyeza kuti alipo matenda a impso. Mapuloteni kapena magazi nthawi zambiri siziyenera kupezeka mu mkodzo ndipo sizizindikiro za matenda a impso. Dokotala ayenera kudziwa ngati kulimbika kwapadera ndi / kapena kutumiza kwa nephrologist n'koyenera.
Zojambula Zamakono
Njirazi zimaphatikizapo kutenga zithunzi za impso pogwiritsa ntchito njira zosiyanasiyana monga ultrasound, CT scan, kapena MRI. Izi zingathandize pakuzindikira mawonekedwe ndi kukula kwa impso. Impso ndi ziwalo zosaoneka bwino za nyemba pafupifupi 8-14 masentimita (3-5.5 mainchesi) kukula (malingana ndi kukula kwa munthu). Matenda ambiri a impso, ndi zina zosiyana, amatha kupotoza impso 'zomangamanga ndipo izi zingatengedwe mosavuta pa mafano. Mmodzi angakhale ndi nthawi yosankha zomwe zimayambitsa matenda a impso / kutayika ngati miyala, obstructions, hydronephrosis, matenda a impso a polycystic, ndi zina zotero.
> Chitsime:
> Hall JE, Guyton AC. (2011). Buku la Buku la Guyton ndi Hall la zachipatala . Philadelphia, PA: Saunders Elsevier.